Fatores de risco para internação por doença respiratória aguda em crianças até um ano de idade / Risk factors for acute respiratory disease hospitalization in children under one year of age

OBJETIVO: Avaliar fatores de risco para hospitalização por doença respiratória aguda em crianças até um ano de idade. MÉTODOS: Estudo de casos e controles na cidade de Pelotas, RS. Os casos foram crianças de até um ano de idade, que se hospitalizaram por doença respiratória aguda, de agosto de 1997 a julho de 1998. Os controles foram crianças da comunidade, da mesma idade, sem hospitalização prévia por essa doença. Um questionário investigando exposição a fatores de risco foi aplicado às mães de casos e controles. Os dados foram submetidos à análise univariada, bivariada e multivariada por meio de regressão logística para avaliação dos fatores de risco sobre o desfecho de interesse. RESULTADOS: Foram analisadas 777 crianças, sendo 625 casos e 152 controles. Na análise bruta, os fatores de risco associados ao desfecho foram: sexo masculino, faixa etária menor de seis meses, aglomeração familiar, escolaridade materna, renda familiar, condições habitacionais inadequadas, desmame precoce, tabagismo materno, uso de bico, história de hospitalização e antecedentes de sintomas respiratórios. O trabalho materno foi fator de proteção para internação por doença respiratória aguda. Na análise multivariada, permaneceram associadas: ausência de ou baixa escolaridade materna (OR=12,5), história pregressa de sibilância (OR=7,7), desmame precoce (OR=2,3), uso de bico (OR=1,9), mãe fumante (OR=1,7), idade abaixo de seis meses (OR=1,7) e sexo masculino (OR=1,5). CONCLUSÕES: Os resultados mostraram a importância dos aspectos sociais e comportamentais da família, assim como morbidade respiratória anterior da criança como fatores de risco para hospitalização por doença respiratória aguda.

OBJECTIVE: To evaluate risk factors for acute respiratory disease hospitalizations in children under one year of age. METHODS: A case-control study was conducted in the city of Pelotas, Southern Brazil. Cases were children under one year of age who were hospitalized due to acute respiratory diseases from August 1997 to July 1998. Controls were same-age community children randomly selected without previous respiratory disease hospitalization. A questionnaire about risk factors exposure was applied to the mothers of cases and controls. Univariate, bivariate and multivariate analyses through logistic regression were carried out to evaluate risk factors for the outcome of interest. RESULTS: There were studied 777 children; 625 cases and 152 controls. In the crude analysis, the risk factors associated with the outcome were: being male, children under six months of age, household crowding, maternal education, family income, inadequate housing conditions, lack of breastfeeding, maternal smoking, use of pacifiers, and a previous history of hospitalization and respiratory symptoms. Maternal working was a protection factor associated with acute respiratory disease hospitalizations. In the multivariate analysis the following risk factors remained associated: maternal education (OR=12.5), previous history of wheezing (OR=7.7), lack of breastfeeding (OR=2.3), use of pacifiers (OR=1.9), maternal smoking (OR=1.7), children under six months of age (OR=1.7), and being male (OR=1.5). CONCLUSIONS: The study results show the importance of the family's social and behavioural aspects as well as previous respiratory disease as risk factors for acute respiratory disease hospitalizations in children under one year of age.

Respiratory syncytial virus infection in children under one year of age hospitalized for acute respiratory diseases in Pelotas, RS

INTRODUCTION: Acute respiratory diseases (ARDs) are a major cause of infant morbidity and mortality. OBJECTIVE: The present case-controlled study investigated the hospitalizations by ARDs in children under one year of age and the association with the respiratory syncytial virus (RSV) in za Pelotas, RS. METHODS: All children under one year of age hospitalized due to ARDs from August 1997 to July of 1998 were followed-up in the four hospitals of the city. A standardized questionnaire was applied to the children's mother regarding symptoms of the actual illness in addition to social and demographic variables, nutrition, and previous morbidity. The final diagnosis of ARDs was performed by an arbiter (a pediatrician) based on the hospital records of the children and the data on the questionnaire. Nasopharyngeal secretions were collected for RSV detection by direct immunofluorescence. RESULTS: The study included 650 children and the annual incidence rate of hospital admissions for ARDs was 13.9 percent. Admissions showed a seasonal pattern with most of the hospitalizations occurring from July to October. The main causes of admission were: pneumonia (43.7 percent), bronchiolitis (31.0 percent), asthma (20.3 percent), influenza (3.5 percent), otitis media (0.8 percent) and laryngitis (0.6 percent). The overall prevalence of RSV was 30.7 percent, with 40.2 percent in bronchiolitis, 28.6 percent in influenza, 27.4 percent in asthma, 26.3 percent in pneumonia, and 25 percent in otitis media. CONCLUSIONS: The results of the present study confirm the high morbidity of ARDs in childhood and the seasonal pattern of ARDs hospitalizations and their association with RSV infection.

The early use of yellow fever virus strain 17D for vaccine production in Brazil - a review

The use of yellow fever (YF) virus 17D strain for vaccine production adapted in Brazil since its introduction in 1937 was reviewed. This was possible due to the availability of official records of vaccine production. The retrieved data highlight the simultaneous use of several serially passaged 17D substrain viruses for both inocula and vaccine preparation that allowed uninterrupted production. Substitution of these substrain viruses became possible with the experience gained during quality control and human vaccination. Post-vaccinal complications in humans and the failure of some viruses in quality control tests (neurovirulence for monkeys) indicated that variables needed to be reduced during vaccine production, leading to the development of the seed lot system. The 17DD substrain, still used today, was the most frequently used substrain and the most reliable in terms of safety and efficacy. For this reason, it is possible to derive an infectious cDNA clone of this substrain combined with production in cell culture that could be used to direct the expression of heterologous antigens and lead to the development of new live vaccines

Uso de chupeta em crianças: contaminaçäo fecal e associaçäo com diarréia / The use of pacifiers by children: fecal contammination and the association with diarrhoea

Inexistem na literatura estudos sobre o possível papel das chupetas na transmissäo da diarréia. Realiza um estudo transversal em 354 crianças menores de dois anos em duas vilas da periferia urbana de Pelotas, RS, Brasil, com precárias condiçöes socioeconômicas. A maioria das crianças (79 por cento) usava chupeta, 15 por cento nunca as haviam utilizado e 6 por cento já haviam abandonado o hábito. Dentre os usuários, 38 por cento passavam a maior parte do tempo fazendo uso da chupeta (uso intenso). Foram realizadas culturas para coliformes fecais em 93 por cento das chupetas em uso, indicando que 49 por cento estavam contaminadas. Nas duas semanas anteriores à entrevista, 35 por cento das crianças apresentaram diarréia - 40 por cento as de uso intenso, 32 por cento entre usuárias em tempo parcial e 37 por cento entre näo usuários. Apesar da forte presença de coliformes fecais, parece näo existir associaçäo entre uso de chupeta e diarréia

O uso da Tapioca como cobertura na titulaçäo viral / The use of tapioca as coverage in viral titration

Virus titration is an important step required on viral vaccines quality control. "Plaque assay", which emplosys several types of everlay media, is usually used on viral titrations. In this paper we describe the use of apioca as an overlay media. Firstly, the toxicity of Tapioca was tested on Vero cells inoculated or not with the Yellow Fever virus (YF) 17 DD vaccine strain. Secondly, different batches of the 17 DD virus using the Tapioca. Tapioca was also shown to be a suitable overlay to be used in thermostability and plaque reduction neutrabilization tests. Other systems could benefit from the use of Tapioca as an overlay, since it was possible to titer. Measles virus in Vero cells. Tapioca is a cheap Brazilian product, is locally available, easy to use, and reliable. Its use is suggested

Molecular analysis of yellow fever virus 17DD vaccine strain

The Oswaldo Cruz Foundation produces most of the yellow fever (YF) vaccine prepared world wide. As part of a broader approach to determine the genetic variability in YF l7D seeds and vaccines and its relevance to viral attenuation the 17DD virus was purifed directly from chick embryo homogenates which is the source of virus used for vaccination of millions of people in Brazil and other countries for half a century. Neutralization and hemagglutination tests showed that the purified virus is similar to the original stock. Furthermore, radioimmune precipitation of 35S-methionine-labeled viral proteins using mouse hyperimmune ascitic fluid revealed identical patterns for the purified 17DD virus and the YF l7D-204 strain except for the 17DD E protein which migrated slower on SDS-PAGE. This difference is likely to be due to N-linked glycosylation. Finally, comparison by northern blot nybridization of virion RNAs of purified 17DD with two other strains of YF virus only fenome-sized molecules for all three viruses. These observations suggest that vaccine phenotype is primarily associated with the accumulation of mutations